Inpatient orthopaedic hardware removal in children: A cross-Sectional study

Boulos, Alexandre; DeFroda, Steven F.; Kleiner, Justin; Thomas, Nathan P.; Gil, Joseph A.; Cruz, Aristides I.

doi:10.1016/j.jcot.2017.06.020

Cited by 17 publications

(17 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are very few studies that have assessed the cost of implant removal outside the setting of infection. 5 , 34 A pediatric database study found that the cost of inpatient implant removal to be on average $11,792. 34 However, this included implant removals for infections.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

et al. 2020

View full text Add to dashboard Cite

Introduction: The relative indications for removing symptomatic implants after osseous healing are not fully agreed on. The purpose of this study was to (1) determine whether patients showed improvement in functional outcomes after the removal of symptomatic orthopaedic implants, (2) compare the outcomes between upper and lower extremity implant removal, and (3) determine the rate of implant removal complications. Methods: A prospective study was conducted between 2013 and 2016. Patients completed a Short Musculoskeletal Function Assessment outcome questionnaire before implant removal and at the 6-month follow-up. Demographic data were stratified and compared between upper and lower extremity groups and between preimplant removal and 6-month postremoval. Results: Of the 119 patients included in the study, 85 (71.4%) were lower extremity and 34 (28.6%) were upper extremity. Significant improvement after implant removal was seen in the dysfunction index ( P ≤ 0.001), bother index ( P ≤ 0.001), and daily activities domain ( P ≤ 0.001). Depression or anxiety ( P = 0.016) were statistically significant predictors for an improved Short Musculoskeletal Function Assessment dysfunction index score at 6 months. The complication rate was 10.1% (n=12) for the cohort. Discussion: Implant removal in both the upper and lower extremity presented notable improvement in dysfunction. Complications that require surgical intervention are extremely rare.

show abstract

Section: Discussionmentioning

confidence: 99%

“… 5 , 34 A pediatric database study found that the cost of inpatient implant removal to be on average $11,792. 34 However, this included implant removals for infections. A recent study reviewed the cost of implant removal for ankle fractures.…”

Section: Discussionmentioning

confidence: 99%

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Vopat et al [ 63 ] showed that leaving the plates in pediatric forearm fractures does not increase the refracture rate compared with the plate removal. Indications for metallic material removal include pain, infection or soft tissue irritation [ 64 ].…”

Section: Platingmentioning

confidence: 99%

Management of pediatric forearm fractures: what is the best therapeutic choice? A narrative review of the literature

et al. 2020

View full text Add to dashboard Cite

Purpose This narrative review intends to summarize the most important and relevant data on diagnosis and treatment of pediatric forearm fractures and to describe the characteristics and advantage of each therapeutic option. Methods We conducted a literature research considering peer-reviewed papers (mainly clinical trials or scientific reviews) using the string “forearm fracture AND epidemiology” or “forearm fracture AND diagnosis or “ forearm fracture AND treatment” or “forearm fracture AND casting” or “forearm fracture AND surgery”. Studies were identified by searching electronic databases (MEDLINE and PubMed) till April 2020 and reference lists of retrieved articles. Only English-language articles were included in the review. Results Conservative management with cast immobilization is a safe and successful treatment option in pediatric forearm fractures. Surgical indication is recommended when an acceptable reduction cannot be obtained with closed reduction and casting. Surgical treatment options are intramedullary nail, plating and hybrid fixation. Conclusions There is not a unique consensus about fracture management and treatment. Further studies are necessary to create univocal guidelines about optimal treatment, considering new techniques and available technologies.

show abstract

“…A refracture can occur after nonoperative and operative treatment, and there is a variable risk period after the removal of hardware of approximately 6 to 12 weeks. 3 It is unusual for these to occur a year later, and the ones reported 7,12 may have been caused by an occult lack of union or simply recurrence from overuse.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have shown even higher (7/12 patients; 58.3%) hardware removal rates for prominence and irritation after screw and washer fixation for medial epicondyle fractures but none for removal of a screw alone, highlighting the importance of the type of hardware used. 14 Boulos et al 3 examined pediatric hardware removal after fracture fixation in 2536 patients and found that infections (32%), mechanical failure (25.4%), and pain (13%) were the most common indications.…”

Section: Discussionmentioning

confidence: 99%

Stress Fractures of the Elbow in the Throwing Athlete: A Systematic Review

Smith

Patel

White

et al. 2018

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background:Stress fractures of the elbow are rare in throwing athletes and present a challenge from both a management and rehabilitation perspective. Although the incidence of stress fractures of the elbow is increasing, there is a lack of data in the literature focused on throwers.Purpose:To evaluate studies regarding the management and outcomes of stress fractures of the elbow in throwing athletes.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review was conducted by searching the Scopus, PubMed, and Cochrane Library electronic databases to identify studies reporting on the management and outcomes of stress fractures in overhead-throwing athletes. Management data included nonoperative and operative modalities, and outcome data included return to play, encompassing the timing and level of activity. Studies were excluded if the stress fracture of the elbow was not a result of a sport injury attributed to throwing or if the study failed to report whether an athlete returned to play.Results:Fourteen studies met the inclusion criteria and were included in this analysis. There were 52 patients in total (50 male, 2 female) with a mean age of 19.7 years (range, 13-29.1 years). The olecranon was the most common location of the stress fracture (51 patients; 98.1%), followed by the distal humerus (1 patient; 1.9%). The majority of patients (n = 40; 76.9%) were treated operatively. Of the 40 patients who were treated surgically, 14 (35.0%) underwent a period of conservative treatment preoperatively that ultimately failed because of persistent nonunion or continued elbow pain. A total of 50 patients (96.2%) returned to sport either at or above their preinjury level. Of the 2 patients (3.8%) who did not return to sport, 1 did not return because of continued elbow pain postoperatively, and the other was lost to follow-up. Complications occurred in 9 patients (17.3%), all of whom were treated surgically.Conclusion:On the basis of this systematic review, the majority of elbow stress fractures were treated operatively and approximately one-third after a period of failed nonoperative management. The return-to-sport rate was high. Further, higher level studies are needed to optimize management and return-to-sport rates in this population.

show abstract

Inpatient orthopaedic hardware removal in children: A cross-Sectional study

Cited by 17 publications

References 31 publications

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

Improvement in Functional Outcomes After Elective Symptomatic Orthopaedic Implant Removal

Management of pediatric forearm fractures: what is the best therapeutic choice? A narrative review of the literature

Stress Fractures of the Elbow in the Throwing Athlete: A Systematic Review

Contact Info

Product

Resources

About